Effectiveness of interventions to improve medication adherence in bipolar disorder

Abstract

While only a few interventions improved adherence, most improved clinical outcomes. Issues were also identified about the way in which adherence is defined. It is proposed that incorporating patient preferences into measures of adherence within the context of a disorder-specific psychosocial intervention may provide an approach that demonstrates both improved adherence and improved clinical outcomes. However this requires further research.

Long-term morbidity in bipolar-I, bipolar-II, and unipolar major depressive disorders

“…Several reports have highlighted the importance of more specifically-tailored interventions for mood disorder patients, ideally by experts and with attention to individual and changing needs and responses. In particular, proposed methods of improving long-term treatment-adherence have ranged from use of long-acting injectable medicines (Gigante et al, 2012) to psychoeducation and disorder-specific psychosocial interventions (Berk et al, 2010;Crowe et al, 2012;Vergouwen et al, 2003). Individualized and critically targeted interventions are more likely to be provided in specialized mood-disorder clinics or centers, accessibility to which should be enhanced and their methods made more widely available (Crowe et al, 2011;Frye et al, 2014;Vieta, 2013).…”

Valued Living and Its Relationship to Medication Adherence in Patients with Bipolar and Comorbid Substance Use Disorders

“…Even though rates of nonadherence are already high in bipolar disorder, comorbid substance abuse has been found to be a strong predictor of poorer treatment adherence (Lingam and Scott, 2002). Many interventions have been studied for improving treatment nonadherence in bipolar disorder over the years, but their effects have either been modest or equivocal, and there are no well-established, efficacious interventions developed to date (Crowe et al, 2012). Furthermore, there is a paucity of studies specifically testing interventions designed to address the unique needs and nonadherence issues in patients with bipolar and comorbid substance use disorders (Gaudiano et al, 2011).…”

Role of Adverse Effects in Medication Nonadherence in Bipolar Disorder

“…[4][5][6] A discussion of these factors is beyond the purview of this article. For a comprehensive overview of the factors related to nonadherence in BD, the reader is referred to Leclerc and colleagues (2013).…”